The mortality risk factor of severe community-acquired pneumonia (SCAP) patients with Sepsis: a retrospective study

Study design This was a single-centre retrospective analysis. Patients with the onset of CAP and conforming to Sepsis (infection +SOFA≥2) were included in the analysis,[8] with the outcome conforming to severe pneumonia. [11-12] The primary outcome was 180-day mortality. The baseline characteristics, clinical outcomes, and prognostic factors related to mortality were assessed. The written informed consent was waived due to the observational nature of the study. Ensure patients’ anonymity. Subjects We retrospectively analyzed the clinical data of 119 patients with SCAP who were treated in the Integrated ICU of The First Affiliated Hospital of Soochow University (a comprehensive tertiary adult hospital) from 1 January 2018 to 30 December 2020. The observation endpoint was 180-day mortality. Our inclusion criteria were: CAP whose outcome met the diagnosis of severe pneumonia and patients who met Sepsis criteria (SOFA≥2) at the onset. Our exclusion criteria were: patients Under 17 years of age. Patients who refused invasive resuscitation. Patients who have incomplete data. Patients whose outcome of treatment is not clear. Patients with unknown or mixed infection (more than one known infection source). Patients with Long-term Sanatoriums and Tend and Protect Hospitals treatment experience. Patients with transplantation, primary lung tumor, or advanced tumors at other sites. Presence of leukopenia or neutropenia (unless due to pneumonia). Adjuvant therapy for severe immunosuppression in human immunodeficiency virus-positive (HIV) patients (CD4 <100). Patients with previous underlying pulmonary diseases (e.g., COPD, asthma, etc.) require long-term home oxygen therapy. Figure 1 shows the flow diagram of the study. Data collection and definition Our study used an electronic medical record system to collect data for retrospective analysis. Our data were recorded by attending nurses and doctors at the time of patients’ presentation to the emergency department (ED). The demographic characteristics of each patient including comorbidities were reviewed thoroughly. We collected the patients' worst vital signs, laboratory results, ventilator support, and use of pressors within 24 hours of admission before initiation of ICU treatment. Score scales were used to calculate the relevant parameters of patients at admission, including APACHE2, SOFA, Pneumonia Severity Index (PSI), and CURB-65(a 5-point score based on confusion, urea, respiratory rate, blood pressure, and age ≥65). [13-16] (table2) Duration of fever, infection markers, respiratory management, and Sepsis medication were recorded during ICU treatment. Pathogenic microorganisms and subsequent antibiotic use of CAP were also collected.